65, and my primary care physician just diagnosed me with borderline high blood
pressure. She gave me a diet to follow and said I need to exercise—which
I am doing. How will I know if my efforts are working?
Stuart Zarich, MD, chief of Cardiology
in the Heart Institute at Bridgeport Hospital, responds:
You are wise to pay attention to your blood pressure. Nearly 90% of all
older people do eventually develop high blood pressure, or hypertension. That
can be dangerous because high blood pressure can cause damaged arteries and
a weakened heart— leading to cardiovascular disease (angina, hardening
of the arteries, heart attack, congestive heart failure, etc.). The sooner
you are aware of elevated blood pressure, the sooner you can take steps to
bring it back down.
There is only one way to know what your blood
pressure is: Have it checked on a regular basis. Hypertension
isn’t usually associated with symptoms.
What Is High Blood Pressure?
Blood pressure is the force that moving blood exerts against the walls of
your arteries. As your arteries grow narrower from blockages, your heart must
work harder to pump blood around your body, and the pressure on the vessel
Your blood pressure consists of two numbers. The
first number is your systolic pressure, measured at the
moment of greatest pressure, while the heart contracts,
sending blood out through the body. The second is the
diastolic pressure, measured while the heart relaxes
According to new guidelines released in May 2003 by the National Heart,
Lung, and Blood Institute, normal blood pressure is below 120/80. This is
the ideal level for heart health.
A systolic pressure between 120–139 and a diastolic
pressure between 80–89 (for example, 130/82)
is considered pre-hypertension, or borderline high
blood pressure. This is a new category, indicating an
increased risk of heart disease.
A systolic pressure between 140–159 and a diastolic
between 90–99 (for example, 153/97) is Stage
1 or mild hypertension.
A systolic pressure above 160 or a diastolic pressure
above 100 is considered Stage 2, or moderate to
If you have been diagnosed with borderline or high
blood pressure, your primary care physician has probably
advised you to eat a diet low in salt and saturated
fats, and to exercise at least 20 minutes every day. If
you cannot control your high blood pressure with diet
and exercise, you may have to take medications if you
are at high risk for coronary disease (for instance, if
you have diabetes) or if you have known coronary
artery disease or kidney disease. It is also a good idea
to have regular blood pressure screenings.
Hospital offers free monthly blood pressure screenings in a number of community
locations. For a referral to a physician, or for information on days, times,
and places for free community blood pressure screenings, call 888-357-2396. English/Spanish,